In these extraordinary times, we are all on the frontlines of COVID-19, struggling to be our best selves while scared and worried about the future. That’s what makes the stories of innovation and courage among Community Health Centers so remarkable. They choose the mission. They choose to step into the arena of a global pandemic no one has ever seen before. They choose to lead, undeterred by uncertainty.
“This is really hard. At times it feels enormous and it feels threatening, threatening to our patients, to our communities and to our colleagues and organizations and ultimately to our families and to ourselves,” observed Daniel Miller, MD, at Hudson River HealthCare, Inc., in Tarrytown, NY. New York is a state virtually in the stranglehold of COVID-19 infections. Miller was on a panel of health center leaders who spoke on a webinar NACHC hosted, Leading in a Crisis: Flattening the COVID-19 Curve. “I think each of us has wondered, am I up to this? Do I know enough? Can I do enough? And yet in the midst of this and with all of these feelings we are all responding and mobilizing in extraordinary ways in a very short time, with imperfect information and constantly changing recommendations and guidelines, we have transformed our practices and workflows.”
Practice Transformation Amid a Pandemic
Clinical practice transformation has happened in a matter of weeks because health centers are best positioned to help take the load from hospitals as COVID-19 ramps up. Health centers have launched testing sites, converted their facilities, transitioned to virtual visits, and developed clinical staffing protocols to adapt to a fluid public health crisis.
“We are being exposed to a new way of practicing medicine,” said Dr. Nikhil Hemady, the chief medical officer of Honor Community Health in a recent interview with Talking Points Memo. “The way I look at it is that we are at war. We are truly practicing medicine like we are at war.”
Starting such an effort during state and countywide lockdowns has triggered a wave of canceled primary, dental, and vision services, causing massive financial losses. The President has signed into law a 3rd Stimulus package that provides some financial relief for health centers and extends mandatory funding through November 2020. But will it be enough? NACHC President and CEO Tom Van Coverden noted, “While we all hope that the next 6-8 weeks allows sufficient time for our country to turn the corner in its fight against COVID-19, health centers, along with many other essential health care providers, will need another infusion of resources very soon. ”
Scavenging for Supplies
Health centers are even devising innovative ways to overcome the shortage of critical supplies such as personal protective equipment. They are reaching out to veterinary practices, dental offices, art conservation operations, and construction sites. “We heard construction companies had N-95 masks, so we reached out and asked if they had any to spare for our staff,” said Beth Wrobel, Chief Executive Officer of HealthLinc in Indiana. “We were able to get 380 N95 masks, which allowed us to put a mask on every health center staff who has potential COVID-19 positive patient [watch Healthlinc’s video here].
The staff at Mary’s Center in Washington, D.C. , which started COVID-19 testing just two weeks ago, are being protected by masks produced by Marymount University physics professor Eric Bubar on PRUSA 3D printers. Sneeze guards to protect the center’s front desk staff were built by a volunteer with 3 ft x 2 ft plexiglass squares found at Home Depot.
Westside Family Healthcare in Wilmington, DE, received a donation from Winterthur Museum’s Art Conservation Lab, which included 2000 medical-grade gloves, about 3 dozen protective eye goggles, N95 masks, and face shields — items normally used to conserve works of art, now helping to save lives. Even local restaurants are helping out, as in the case of Amelia’s Pizzeria and Restaurant in Christiansburg, VA, which sent a donation of disposable gloves to the Community Health Center of the New River Valley. Stone Mountain Health Services in Hurley, received PPE and cleaning supplies from a nearby school and a local builders’ supply store.
The Weeks Ahead
We know this is a rapidly changing situation and everything will look different in a matter of weeks. We are drinking out of a virtual fire hydrant to keep pace with the new normal of COVID-19 and the confounding ways health care delivery is adapting. We will try to keep you posted with regular posts about what health centers are doing on the front lines. Stay safe.